CMS Establishes New Category I CPT Add-On Code for Coronary IVL

November 3, 2023—Shockwave Medical, Inc., announced today that as part of the Calendar Year 2024 Physician Fee Schedule (PFS) final rule, the United States Centers for Medicare & Medicaid Services (CMS) has established a Category I Current Procedural Terminology (CPT) add-on code for procedures involving coronary intravascular lithotripsy (IVL). These updates will become effective January 1, 2024.

According to Shockwave, the new CPT code, +92972, has been created to describe when coronary IVL is performed and has been assigned work relative value units (RVU) and professional fees that remunerate physicians for the additional work associated with performing coronary IVL.

Because +92972 is an add-on code, the work RVUs and fees associated with coronary IVL will be added to the remuneration physicians receive for percutaneous coronary intervention procedures, including when atherectomy is also performed.

Shockwave advised that before the establishment of CPT code +92972, there were no additional RVUs or fees for physicians who performed coronary IVL. CMS first proposed the new CPT add-on code via the FY2024 Proposed PFS which, following a 60-day public comment period, has now been finalized.

As outlined by Shockwave, the relevant code is as follows:

• CPT: +92972
• Description: Percutaneous transluminal coronary lithotripsy
• Additional Work RVUs: +2.97
• Additional Payment: +$140 (Note 1: CMS-1784-F; Medicare PFS Fiscal Year 2024 Final Rule. Note 2: Payment rates do not take into account geographical or additional adjustments. Providers should contact their local Medicare Administrative Contractor or CMS for specific information as payment rates vary by region.)

Robert Fletcher, Senior Vice President of Marketing and Market Access at Shockwave Medical, stated in the press release, “We would like to thank the cardiology medical societies, the American Medical Association CPT editorial panel and staff, and CMS for their work in establishing a new CPT code for coronary IVL. Now that additional work RVUs and professional fees are associated with coronary IVL, we believe physicians will be appropriately remunerated for their commitment to adequate lesion preparation in these complex interventions involving calcified coronary arteries.”